Provider Demographics
NPI:1831637156
Name:WASHINGTON, GEORGE JR (MHS)
Entity Type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:
Last Name:WASHINGTON
Suffix:JR
Gender:M
Credentials:MHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12151 I 10 SERVICE RD
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70128-2433
Mailing Address - Country:US
Mailing Address - Phone:504-957-4153
Mailing Address - Fax:
Practice Address - Street 1:12151 I 10 SERVICE RD
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70128-2433
Practice Address - Country:US
Practice Address - Phone:504-957-4153
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-07
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health